<script type="text/javascript" src="../js/jquery.validate.min.js"></script>
<script type="text/javascript" src="../js/app/app.authIteraction.js"></script>
<script type="text/javascript">
    $$.app.authIteraction.registerHanler();
</script>
<div class="container2" id="registerform">
	<section class="main">
		<form class="form-3" name="formregister" id="formregister" onsubmit="return false;">
            <ul class="errWrapper">
            </ul>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Tên truy cập</label>
					</div>
					<div class="rightform">
						<input type="text" name="username" id="username">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="password">Mật khẩu</label>
					</div>
					<div class="rightform">
						<input type="password" name="pass" id="pass">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="password">Xác nhận mật khẩu</label>
					</div>
					<div class="rightform">
						<input type="password" name="repass" id="repass">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Email</label>
					</div>
					<div class="rightform">
						<input type="text" name="email" id="email">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Họ và tên</label>
					</div>
					<div class="rightform">
						<input type="text" name="fullname" id="fullname">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Số điện thoại</label>
					</div>
					<div class="rightform">
						<input type="text" name="mobilephone" id="mobilephone">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Giới tính</label>
					</div>
					<div class="rightform">
						<select name="gender" id="gender" style="background-color:#000;border-radius:40px;color:#fff;font-family: 'BebasNeueRegular', 'Arial Narrow', Arial, sans-serif;">
							<option style="background-color:#222;" value=""> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Chọn &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </option>
							<option style="background-color:#222;" value="1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nam  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </option>
							<option style="background-color:#222;" value="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nữ  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </option>
						</select>
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Năm sinh</label>
					</div>
					<div class="rightform">
						<select name="birthyear" id="birthyear" style="background-color:#000;border-radius:40px;color:#fff;font-family: 'BebasNeueRegular', 'Arial Narrow', Arial, sans-serif;">
							<option style="background-color:#222;" value="">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Chọn  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </option>
							<?php
								$mydate=getdate(date("U"));
								for($i=($mydate[year]-12);$i>=1950;$i--){
							?>
									<option value="<?php echo $i; ?>">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <?php echo $i; ?></option>
							<?php
								}
							?>	
						</select>
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Thành phố</label>
					</div>
					<div class="rightform">
						<select name="city" id="city" style="background-color:#000;border-radius:40px;color:#fff;font-family: 'BebasNeueRegular', 'Arial Narrow', Arial, sans-serif;">
							<option style="background-color:#222;" value="">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Chọn  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </option>
							<option style="background-color:#222;" value="Hà Nội"> &nbsp;&nbsp;&nbsp; Hà Nội </option>
							<option style="background-color:#222;" value="Sài Gòn">&nbsp;&nbsp;&nbsp; Sài Gòn </option>
							<option style="background-color:#222;" value="Nơi Khác">&nbsp;&nbsp; Nơi Khác</option>
						</select>
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Tên cửa hàng</label>
					</div>
					<div class="rightform">
						<input type="text" name="shopname" id="shopname">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="wrapper">
					<div class="leftform">
						<label for="login">Địa chỉ cửa hàng</label>
					</div>
					<div class="rightform">
						<input type="text" name="addressshop" id="addressshop">
					</div>
				</div>
			</p>
			<p class="clearfix">
				<div class="leftform">
					<label for="login">Địa chỉ Facebook </label>
				</div>
				<div class="rightform">
					<input type="text" name="addressfacebook" id="addressfacebook">
				</div>
			</p>
			<p class="clearfix">
				<div class="leftform">
					&nbsp;
				</div>
				<div class="rightform">
					<input type="submit" class="btnSubmit" name="validateRegister" value="Đăng Ký">
				</div>
			</p>
		</form>​
	</section>
</div>